CN104703535B - Pulsometers for newborn babies - Google Patents

Abstract

The pulsometer comprises a first electrode (4) and a second electrode (5) adapted to be arranged in contact with a body part (9) of a patient. The first and second electrodes (4, 5) are arranged on a first arm (1) and a second arm (2), respectively. The first and second arms (1, 2) extend from a central portion (3), and respective first ends (4a, 5a) of the first and second arms (1, 2) are arranged to bend away from each other when the pulsometer (10) is arranged in an application position on the body part (9) of the patient.

Description

Pulsometers for newborn babies

The invention relates to a pulsometer for measuring the pulse rate of a patient. In particular, the present invention relates to a pulsometer for newborn infants. The pulsometer has a simple structure and mode of operation, and can be quickly and easily applied to the torso/belly portion of the patient.

More particularly, the present invention relates to a pulsometer comprising first and second electrodes adapted to be arranged in contact with a body part of a patient.

background

Pulsometers for measuring the pulse of a patient are well known. For example, pulsometers worn by athletes during sports have become popular.

A pulsometer suitable for use by medical personnel needs to be suitably constructed to be properly attachable to the appropriate part of the patient's body. Therefore, it is desired that the pulsometer should have a simple structure and be basically wearable with respect to a specific part of the patient's body.

Patent publication US6928317 discloses a wearable heart rate transmitter comprising a strap and a main body. The strips are ribbon shaped. Conductive rubber sheets extend on both ends of the central hole. The main body part is installed in the hole of the strap, and the two contact ends of the rubber plate are pressed at two contact points to contact the contact ends in the hole. In this way, the rubber plate touches the body part to measure the beating of the heart.

This prior art pulsometer likewise also other prior art pulsometers known in the art exhibits a complex structure and mode of operation.

Other known devices are JP2003325466, US2007/0038048, GB2020981 and US2007/123756.

Pulsometers known in the art do not meet the requirements for quick and easy mounting on the torso of the human body.

this invention

The present invention provides a pulsometer having at least two electrodes positioned on two arms extending from a central portion so that the pulsometer can be quickly and easily mounted to the torso of a patient's body whenever a pulse rate measurement is required part.

The main object of the present invention is to provide a pulsometer with simple structure and function.

According to the invention there is provided a pulsometer comprising a first electrode and a second electrode adapted to be arranged in contact with a body part of a patient. The first electrode and the second electrode are respectively arranged on the first arm and the second arm. First and second arms extend from the central portion, and respective first ends of the first and second arms are arranged to bend away from each other when the pulsometer is arranged in an application position on a patient's body part.

In an applied position on the patient's body part, the first arm and the second arm are biased toward each other using a force transmitted from the first electrode and the second electrode to the patient's body part.

According to a preferred embodiment, the third electrode is arranged at the position of the central part and is adapted to contact the patient's body part when the pulsometer is in the application position. The third electrode will typically be arranged in a location on the body part between the first electrode and the second electrode.

The first and second arms and the central portion may preferably together form a curved bow. In such an embodiment, the first electrode and the second electrode are arranged to the curved bow and face inwardly.

The first electrode and the second electrode have a generally planar surface for contacting the patient's skin, and the generally planar surface is between 7 cm ² and 19 cm ² .

The pulsometer may comprise means for applying a high frequency between the electrodes, ie substantially higher than the frequency used for pulse measurement.

The actuator is advantageously connected to the inside of the curved bow at two attachment portions, and there is a gap between the actuator and the curved bow. When the actuator is compressed into the gap towards the curved bow, the first and second arms will move away from each other, making it possible to mount the pulsometer on a patient's body part, usually the torso of a newborn baby. Preferably the third electrode is arranged on the actuator.

In an alternative embodiment, the first and second arms are connected at the central portion using a hinge.

Furthermore, the first arm and the second arm are preferably continuous along said central portion. In such an embodiment, the first arm and the second arm may be part of the same component (one piece). Such a part may advantageously be an arcuate flexible piece having a U-shape or similar shape.

In yet another alternative embodiment of the pulsometer, the first arm and the second arm present respective further ends opposite the first end. In this embodiment, the first arm and the second arm are connected to each other using a hinge arranged between the first end and the second end, wherein a spring is arranged between the first arm and the second arm between the hinge and the other in the position between the ends. Such an embodiment is depicted in Figure 6c.

Preferably, the first arm and the second arm are arranged symmetrically around the central portion.

These electrodes are preferably electrically connected to a wireless communication output device. In this way, a user such as a midwife or other medical personnel can read the measured pulse on an attached screen or digital output display.

In a preferred embodiment, the digital output display is located on the exterior face of the pulsometer. In such an embodiment, no additional equipment is required to use the pulsometer. That is, the measured pulse rate is replaced on the pulsometer itself.

Detailed example of implementation

Having described the main features of the invention above, a more detailed and non-limiting description of certain exemplary embodiments will now be given with reference to the accompanying drawings, wherein,

Figure 1a is a perspective view of a pulsometer according to a preferred embodiment;

Figure 1b is an exploded view of the pulsometer of Figure 1a;

Figure 1c is a block diagram illustrating the functionality of a pulsometer;

Figure 1d is a perspective view of a pulsometer according to an alternative embodiment;

Figure 2 is a view of the preferred embodiment when opened for application to a body part;

Figure 3 is a view showing a preferred embodiment of its application on a body part;

Figure 4 is a view showing a preferred embodiment of the removal of the pulsometer;

Figure 5 is a view showing a preferred embodiment of a pulsometer in use on a body part;

Figure 6a is a front view of a preferred embodiment of the pulsometer shown in Figure 1;

Figure 6b is a front view of another embodiment of a pulsometer; and

Figure 6c is a front view of another embodiment of the pulsometer of the present invention.

Some embodiments of the invention are described below. These embodiments are illustrative only, and non-limiting, for the understanding of the invention.

When referring to "above" or "below" and "top" and "bottom", "side", "inner", "outer" and similar terms in the following, it refers strictly to the embodiment as shown in the drawings .

It should also be understood that during use, the pulsometer may be oriented differently than that shown in the figures without departing from the principles of the invention.

Like reference numerals denote corresponding features in the figures.

Figure 1a shows an isometric view of a preferred embodiment of pulsometer 10 when not in use. Pulsometer 10 has a generally U-shaped bow and includes a first arm 1 and a second arm 2 extending from a central portion 3 . Arm 1 , arm 2 and central part 3 are all made of an easily bendable but fairly elastic material such as nylon or plastic. The material can also be a flexible metal. Alternatively, the arms may be rigid, but connected to the central part by a flexible part. The first arm has a free end 4a and the second arm has a free end 5a. The first electrode 4 is arranged on the first arm 1 and the second electrode 5 is arranged on the second arm 2 . The third electrode 6 is located at the central part 3, facing the U-shape.

The first electrode 1 and the second electrode 2 are preferably made of steel or another metal with good electrical coupling. The face of the electrode to be in contact with the body of the newborn baby has a relatively large flat area. It is preferably circular with a diameter of about 4 cm. The first electrode 1 and the second electrode 2 are coupled to the U-bow by snap fittings, eg of the button type. The electrodes are thus easily removed for cleaning or replacement. It is also possible, if desired, to replace the first electrode 1 and the second electrode 2 with smaller, ie normal-sized electrodes. The surfaces of the flat areas of the electrodes 1, 2 are smooth to allow easy cleaning. When in use, the electrodes are dry.

The third electrode is not critical to the function of the pulsometer, but is advantageous as it will provide a zero point for the applied common mode voltage and thus serve to reduce noise.

The elasticity of the U-bow is configured such that the first and second electrodes are pressed against the body of a newborn baby with about the same force as a stethoscope. The pulsometer of the present invention can also be cleaned using the same procedure as used to clean a stethoscope.

Referring to Figure Ib, which shows the pulsometer in exploded view, the internal parts of the pulsometer will now be explained. The bow preferably has an inner core 21 made of spring steel. The spring steel core 21 preferably extends along the entire length of the bow and is surrounded by plastic or rubber housing parts 22 and 23 . Alternatively, the bow can be covered with elastic plastic or rubber during the molding process. The spring steel is selected from high-quality steel whose elasticity with respect to the spring does not substantially degrade over time.

One of the housing parts 22 has a cavity in which a printed circuit board 24 is accommodated. The circuit board 24 has wires 25 a , 25 b and 25 c connecting the circuit board 24 and the three electrodes 4 , 5 and 6 . As explained above, the electrodes 4 and 5 are attached to the bow by a snap fit. To facilitate this, the snap buttons 26a, 26b for the respective electrodes 4, 5 are attached at the ends of the bow by rivets 27a, 27b extending through the respective holes 28a. Rivets 27a, 27b may also be used to attach wires 25b and 25c to snap buttons 26a, 26b.

The third electrode 6 may also be attached by means of bolts 29a, 29b and nuts 30a, 30b. The wire 25a may be attached to the electrode 6 via one of the bolts 29a, 29b.

Figure 1c shows a block diagram of the operation of the pulsometer. The main electrodes 4 and 5 are connected to an EGC amplifier 31 which amplifies the signal from the electrodes and feeds it to a microcontroller 32 . An impedance detector unit 33 is also coupled to the electrodes 4, 5 to detect impedance above a certain level (indicating that the electrode is not making skin contact) and below a certain level (indicating that the electrode is short circuited). Signal 34 is sent to microcontroller 32 to set microcontroller 32 in the appropriate mode. If the impedance level is outside a predetermined range, the microcontroller 32 will reject the heart rate measurement. Alarms can be activated to alert the user. If this impedance is very high, this may indicate that the pulsometer is not placed on the baby. Thus, the microcontroller can turn off power to the pulsometer after a certain delay.

The third (middle) electrode 6 is coupled to the EGC amplifier 31 via a neutral electrode drive unit 35 . As mentioned above, the third electrode 6 is used to cancel noise.

The temperature sensor 36 can also be integrated with the third electrode 6, or placed close to the electrode 6, in order to measure the baby's skin temperature.

A battery 37 with charge and a power control unit 38 deliver power to the microcontroller and associated circuitry.

A microphone 39 and a light sensor 40 for detecting ambient sound and light are also coupled to the microcontroller 32 . One or more tension sensors 41 are also coupled to the microcontroller 32 . A 3-axis accelerometer 42 is coupled to the microcontroller 32 . A display unit 43 may be coupled to the microcontroller 32 and a wireless transmitter 44 may be coupled to the microcontroller 32 . Alternatively or additionally, a wired connection 20 may be provided.

The functions and applicability of the above units will be described in more detail below.

The pulsometer is preferably connected via a cable 20 to a base unit (not shown). Alternatively, the pulsometer can be wirelessly connected to the base unit. However, for hospital use, a wireless connection is less preferred because of the risk of interference with other types of equipment. If the wireless option is chosen, the pulsometer will have an internal power source, such as a battery. The battery is preferably rechargeable, for example by connecting the pulsometer to the base unit.

Preferably, both the pulsometer and the base unit have automatic on/off switches. When not in use, the pulsometer may be adapted to be attached to the base unit. When the base unit senses that a pulsometer is attached to it, it will turn off, as will the pulsometer itself. The system will turn itself on as soon as the pulsometer is detached from the base unit. This feature can be implemented in both wired and wireless systems. A convenient method of detecting whether a pulsometer is attached to the base unit is by measuring the impedance between the first electrode and the second electrode. Impedance measurements can also be used to detect whether a pulsometer is attached to the infant. If substantially infinite impedance is detected during a set period of time, the system will assume that the pulsometer is not in contact with the body and the system will shut itself off.

The base unit is equipped with a screen to display the pulsometer readings. A base unit with a screen is preferred over a screen on a pulse meter because this enables pulse readings to be taken even when the newborn baby (and thus the pulse meter) is covered by a blanket.

The pulsometer bow may also be equipped with means for measuring the amount of bending of the bow, for example by means of tension bands placed at the transitions of the arms and the central part or by measuring the distance between the two arms arranged to splay the bow. For example, the distance can be measured using a cord potentiometer by attaching the potentiometer with a cord reel to one arm of the bow, preferably near the central portion of the bow, and the outer end of the cord to the opposite arm. When the arm bends outward, the wire will turn the reel and thus change the resistance of the potentiometer. A spring can be used to wind up the wire when the arms are moved towards each other again. Another alternative could be to use a light source or laser source and a reflector to measure distance from the speed of light. Then, it must be ensured that nothing will block the light path during use.

It is possible to measure chest diameter and chest expansion by any of the methods described above or other methods readily available to the skilled artisan. Chest diameter is an indication of neonatal weight and can be used to provide the desired target for the desired ventilation since target ventilation is mostly expressed in millilitres per kg body weight. When the pulsimeter is placed across the neonatal trunk, the tension in the straps is automatically calibrated such that the minimum tension is assigned the value for an empty lung and the maximum tension is assigned the value for a fully inflated lung. The system can thus provide an estimate for chest expansion in approximate millilitres per ventilation. While the amount of air changes may not be very precise, at least the system will be able to count the number of air changes per minute. If the chest expansion is substantially reduced relative to normal newborn infants, ie the frequency of tension fluctuations falls below a certain value, an alarm may be activated to indicate that the infant has stopped breathing or is breathing too little. This can be as an audible sound or as a visual signal or both. An alarm can also be activated if there is a large increase in respiratory rate, as this may be a sign of hyperventilation.

An alternative method of detecting that the pulsometer is not attached to the body is by monitoring the tension band. If the belt is in idle mode (ie not stretched) for an extended period of time, the pulsometer can be considered not in contact with the patient's body.

As an alternative or additional feature, the pulsometer may also be equipped with one or more accelerometers. Accelerometers can be used on their own to detect chest expansion or can be used in conjunction with tension straps to calibrate these. Accelerometers are also suitable for detecting other types of movement in infants, such as spasticity, infant handling and stimulating movements during resuscitation.

Chest expansion can also be detected by impedance measurement. The impedance applied to detect chest expansion will have a much higher frequency than the ECG (electrocardiogram) measurement so as not to interfere with the ECG measurement.

The pulsometer may also have one or more temperature sensors to detect changes in the baby's temperature. The temperature sensor will likely not be able to measure absolute temperature, but will be able to detect if the baby has gotten colder or hotter than it started.

The pulsometer may also have at least one photodiode or similar light sensor to detect if the newborn is covered in blankets. Newborn babies, especially premature babies, can catch colds easily if they are not covered with a blanket or the like. This feature will provide additional security against the infant being left uncovered.

The pulsometer may also be provided with a microphone to detect sounds from the baby, such as crying or whimpering. If the sound is close to medical personnel or another receiver, the sound can reach the base unit. There may also be filters to cancel out other sounds from the surroundings. Optionally, actual baby sounds are sent to the base unit, which can also emit an audible cue indicating that the baby is crying.

Using this system, it is possible to measure and detect several functions as described above. It can detect if the baby is breathing or is apnea. This is especially important in developing countries where newborn babies may lie for extended periods of time without continuous supervision. If a potentially critical condition is detected, or if a drastic change in conditions is detected, an alert can be sounded to draw the attention of nearby medical personnel.

The pulsometer or preferably the base unit can also be equipped with a clock display. This is especially useful in developing countries where medical staff often do not have watches. The clock can also have a stopwatch function to facilitate manual pulse diagnosis.

The base unit may also be adapted to connect to other types of medical equipment, such as an oxygen sensor for determining blood oxygen saturation. A more complete picture of the newborn baby's condition can thus be determined and correlations between different measurements can be facilitated.

Figure Id shows an isometric view of an alternative embodiment of pulsometer 10 when not in use. It comprises a first arm 1 and a second arm 2 extending from a central part 3 . Both the arms 1, 2 and the central part 3 are made of an easily bendable but rather elastic material such as nylon or plastic. The material can also be a flexible metal. The first arm has a free end 4a and the second arm has a free end 5a. The first electrode 4 is arranged on the first arm 1 and the second electrode 5 is arranged on the second arm 2 .

Figure 2 shows the pulsometer 10 in an open position, ready to be placed on a patient's body part, such as the torso of a newborn baby. There is an actuator 7, which is flexible. Both ends of the actuator 7 are attached to the first arm 1 and the second arm 2 at portions remote from the free ends 4 a , 5 a and also from the first electrode 4 and the second electrode 5 . These attachment locations of the two ends of the actuator 7 are on the inner side of the curved shape of the pulsometer 10 , adjacent to the central part 3 . The actuator 7 should be flexible such that when forced towards the central portion 3 of the pulsometer 10, the actuator 7 bends into a less curved shape.

FIG. 3 shows the pulsometer 10 in the same position as in FIG. 2 , but shown relative to the body part 9 of a newborn baby on which the pulsometer is intended to be applied.

Alternatively, one of the ends of the actuator 7 may be slidably attached to one of the arms 1, 2 of the pulsometer 10, and the other end may be fixedly attached. In such an embodiment the actuator 7 should be relatively rigid in order to provide an expansive mutual movement between the first and second arms 1 , 2 .

Referring to FIG. 1d , there is a gap 11 between the inside of the central part 3 and the actuator 7 .

It can also be seen from Figure 1 that the pulsometer 10 is continuous along the central portion 3, forming a curved bow.

A third electrode 6 ( FIG. 1 ) is located on the actuator 7 close to the central portion 3 . All electrodes 4 , 5 , 6 are located inside the curved shape/bow of the pulsometer 10 . For the operation of the pulsometer, the third electrode 6 is not absolutely necessary. The third electrode 6 is essentially used to reduce noise from the measurement signal. These electrodes are preferably made of steel.

The structure of the pulsometer 10 shown in Fig. 1 is such that the pulsometer 10 is flexible and the central part 3, the first arm 1 and the second arm 2 form a curved bow. The first electrode 4 and the second electrode 5 are arranged on a curved bow and face inwards. In the shown embodiment, the first electrode 4 and the second electrode 5 are arranged close to the free ends 4a, 5a.

There is an electrical circuit (not shown) connected to the electrodes, which is adapted to provide an output signal to the user. In one embodiment, the output signal may be communicated via wireless communication to a user interface, such as a computer screen or simple digital display.

In an alternative embodiment, each electrode may be connected to an electrical wire by an electrical connector 17 (visible in Figures 3 and 4). This circuit can then be arranged at another location than on pulsometer 10 .

In another alternative embodiment, the pulsometer 10 comprises two electrical circuits connected to the three electrodes 4, 5, 6 and a digital display 19 arranged, for example, on the central part 3 on the outside of the curved arc. superior. This embodiment is shown in FIG. 5 . The actuator 7 is not visible in this figure because it is arranged between the central part 3 (with the digital display 19 ) and the patient's body part 9 . The pulsometer 10 according to this embodiment needs to be provided with a power source, such as a battery.

2-5 are views of the pulsometer 10 of FIG. 1 as it is used by a midwife or any other user. Reference will again be made to these figures when illustrating the operation of the preferred embodiment

Fig. 6a is a schematic side view of the pulsometer 10 shown in Fig. 1 .

Figure 6b is a side view of another embodiment of a pulsometer 10 in which the first arm 1 and the second arm 2 are connected by a hinge 12 at the central part 3 of the pulsometer. Other features are the same as in Fig. 1 and are not repeated for brevity. It should be noted that in this embodiment the first arm 1 and the second arm 2 need not exhibit inherent flexibility when the hinged connection 12 is included therebetween. The flexible and elastic properties can be provided by the flexibility of the hinge 12 and the actuator 7 . It may also be provided by a biased hinge 12, for example with a spring (not shown).

Another embodiment of pulsometer 10 is shown in FIG. 6c. The first arm 1 and the second arm 2 are connected to each other at a hinge 12 at a central part 3 . The first arm 1 and the second arm 2 have in their upper part two further free ends 14, 15 above the hinge 12 for grasping and operating the pulsometer. A spring 16 is located between the first arm 1 and the second arm 2 above the hinge 12 and is attached to the first arm 1 and the second arm 2 at points 13 , 18 near the further free ends 14 , 15 . The third electrode 6 is located on the second arm 2 at a suitable point below the hinge 12 such that proper contact with the patient's body is ensured at a position between the first electrode 4 and the second electrode 5 . The third electrode may instead be located on the first arm 1 close to the central part 3 .

In the embodiment shown in FIG. 6 c , the arms 1 , 2 may be of substantially no spring action material, and the spring action is then provided by the spring 16 . The further ends 14, 15 are compressed by the user, so that the spring 16 must also be compressed and the further ends 14, 15 approach each other. In this case, the free ends 4 a , 5 a are moved away from each other via the hinge joint 12 .

In this open state, the pulsometer 10 is placed on the patient's body 9 with pressure still exerted on the spring 16 . Due to the spring action, the two arms 1, 2 always try to return to their original position, so when the pressure on the spring 16 is released, the arms 1, 2 together with the electrodes 4, 5 fixed on them are held firmly by the force of the spring. press on the patient's body. Precisely, once the compression is released, the further free ends 14, 15 move away from each other due to the spring action and the free ends 4a and 5a move inwardly towards each other.

In all the embodiments shown in the figures, the first arm 1 and the second arm 2 are arranged symmetrically around the central part 3 of the pulsometer 10 . However, this is not mandatory for achieving the purpose of the present invention.

The operation of the pulsometer 10 shown in FIGS. 1 b to 5 will now be further explained.

As shown in Figure 2, the actuator 7 is compressed by the user 8 in order to open the pulsometer 10 so that the two free ends 4a, 5a together with the first 4 and second 5 electrodes move away from each other. Thus, pressing the actuator 7 towards the central part 3 opens the pulsometer 10 .

In this open state, the pulsometer is placed on the patient's body part 9 with pressure still exerted on the actuator 7 . Due to the elastic or spring action of the material, the two arms 1 and 2 always try to return to their original form. So, when the pressure on the actuator 7 is released, the arms 1, 2 together with the electrodes 4, 5 fixed thereon are pressed firmly against the patient's body part 9 by the spring force.

FIG. 3 shows how the user 8 can easily hold the pulsometer 10 in the open position (also shown in FIG. 2 ) using one hand and easily place the pulsometer over the abdomen of the newborn baby's torso 9 . This is made easier because the two ends 4a, 5a have been moved away from each other. Thus, the pulsometer 10 can be quickly installed using one hand as soon as a pulse rate needs to be recorded.

Notably, when the user compresses the actuator 7, the gap 11 between the inner side of the central part 3 and the actuator 7 is minimized. This is the effect of gap 11. It makes it possible to compress the actuator 7 by the user 8 . When the grip is released from the actuator 7, the third electrode 6 will move towards the patient's body part 9 as the actuator 7 moves towards its original and more curved shape/position (as shown in Figure 1). In the application mode, the three electrodes 4 , 5 , 6 are in sufficient contact with the body part 9 .

FIG. 4 shows that the pulsometer has been removed from the body part 9 . The actuator 7 has been released causing the first 1 and second 2 arms and the electrodes 4, 5 to move towards each other.

The invention has been described with reference to certain embodiments for the sake of understanding only, and it will be apparent to those skilled in the art that the invention encompasses many modifications within the scope of the appended claims. In particular, the features explained with respect to FIG. 1 can also be easily implemented in the embodiment of FIGS. 1 b to 5 .

Claims (28)

1. A pulsometer comprising a first electrode (4) and a second electrode (5) adapted to be arranged in contact with a body part (9) of a patient, said first electrode and said second electrode (4 , 5) respectively arranged on the first arm (1) and the second arm (2), the first arm and the second arm (1, 2) extending from the central part (3), and the first The respective first ends (4a, 5a) of one arm and said second arm (1, 2) are arranged so that when said pulsometer (10) is arranged in an application position on a patient's body part (9) bending away from each other, characterized in that said first and said second arms (1, 2) and said central part (3) together form a curved bow equipped with a device for measuring said bending the amount of curvature of the bow or the distance between the arms of the curved bow and thereby monitor the breathing of the patient, and wherein the first and second electrodes (4, 5) are arranged to the curved and facing inwardly, and in the applied position on the patient's body part (9), the first and second arms (1, 2) are biased towards each other using a force from the first An electrode and said second electrode (4, 5) are applied to a patient's body part (9). 2. The pulsometer of claim 1, wherein the means for measuring the amount of bending of the curved bow or the distance between the arms of the curved bow and thereby monitoring the breathing of the patient comprises At least one tension band, wire potentiometer, light emitter and reflector. 3. The pulsometer of claim 1, wherein the means for measuring the amount of bending of the curved bow or the distance between the arms of the curved bow and thereby monitoring the breathing of the patient comprises At least one tension band, wire potentiometer, laser transmitter and reflector. 4. The pulsometer according to claim 1, characterized in that a third electrode (6) is arranged in the position of the central part (3) and is suitable for when the pulsometer (10) is in the application position contact with patient body parts (9). 5. A pulsometer according to any one of claims 1 to 4, characterized in that the first and second electrodes (4, 5) are snap-fitted to their respective arms (1, 2 ). 6. The pulsometer according to any one of claims 1 to 4, characterized in that the first electrode and the second electrode (4, 5) are metal or other materials with good electrical coupling Material. 7. A pulsometer according to any one of claims 1 to 4, characterized in that the first and second electrodes (4, 5) are steel. 8. A pulsometer according to any one of claims 1 to 4, characterized in that the first and second electrodes (4, 5) have substantially planar surfaces for contact with the patient's skin , the generally planar surface is between 7 cm ² and 19 cm ² . 9. The pulsometer according to any one of claims 1 to 4, characterized in that the pulsometer comprises at least one accelerometer. 10. The pulsometer according to any one of claims 1 to 4, wherein the pulsometer includes a device for applying between the first electrode and the second electrode substantially higher than the A device that measures the frequency of the pulse. 11. The pulsometer according to any one of claims 1 to 4, characterized in that it comprises at least one temperature sensor. 12. The pulsometer according to any one of claims 1 to 4, characterized in that the pulsometer comprises at least one light sensor to detect whether the patient is covered. 13. A pulsometer according to any one of claims 1 to 4, wherein the pulsometer comprises a microphone adapted to communicate with a remote receiver. 14. A pulsometer according to any one of claims 1 to 4, wherein the pulsometer is wired or wirelessly connected to a base unit which includes a interface device. 15. The pulsometer of claim 14, wherein the interface means for providing feedback to a caregiver comprises a display, a light generating means or a sound generating means. 16. The pulsometer of claim 14, wherein the pulsometer is adapted to be attached to the base unit when not in use, and wherein the pulsometer includes means for responding to the pulsometer being A device attached to the base unit or not attached to the base unit to turn power on and off. 17. The pulsometer of claim 14, wherein the pulsometer is adapted to be attached to the base unit when not in use, and wherein the pulsometer includes a device for measuring by the first electrode and an impedance on the second electrode to switch power on or off in response to the pulsometer being attached or not attached to the base unit. 18. The pulsometer according to any one of claims 1 to 4, wherein the pulsometer includes means for detecting a substantially infinite impedance between the first electrode and the second electrode and if Detection of substantially infinite impedance over a certain period of time shuts down the pulsometer means. 19. A pulsometer according to claim 2 or 3, characterized in that it comprises means for switching off the pulsometer if the tension band is in the non-stretched mode for a prolonged period of time . 20. A pulsometer according to claim 4, characterized in that the actuator (7) is connected to the inner side of the curved bow by means of two attachment parts on its end, and wherein the actuator There is a gap (11) between (7) and said curved bow. 21. The pulsometer according to claim 20, characterized in that the third electrode (6) is arranged on the actuator (7). 22. The pulsometer according to any one of claims 1 to 4, characterized in that the first arm (1) and the second arm (2) use a hinge (12) in the central part ( 3) to connect. 23. The pulsometer according to any one of claims 1 to 4, characterized in that said first arm (1) and said second arm (2) are continuous along said central part (3) of. 24. The pulsometer according to any one of claims 1 to 4, characterized in that the first arm (1) and the second arm (2) present a , 5a) opposite respective further ends (14, 15), and said first arm and said second arm (1, 2) are arranged using said first end (4a, 5a) and said A hinge (12) between said further ends (14, 15) is interconnected, wherein a spring (16) is arranged in a position between said hinge (12) and said further ends (14, 15) Between said first arm (1) and said second arm (2). 25. The pulsometer according to any one of claims 1 to 4, characterized in that the first arm (1) and the second arm (2) are arranged symmetrically about the central part (3) . 26. The pulsometer according to any one of claims 1 to 4, characterized in that the first electrode and the second electrode (4, 5) are electrically connected to a wireless communication output device. 27. The pulsometer according to claim 4, characterized in that said first electrode, said second electrode and said third electrode (4, 5, 6) are electrically connected to a wireless communication output device. 28. A pulsometer according to any one of claims 1 to 4, characterized in that a digital output display (19) is located on the outer face of the pulsometer (10).